Dubai: Rare spine corrective surgery performed for the first time in the Middle East

A 13-year-old Jordanian girl was treated for scoliosis with a corrective surgery which was performed successfully for the first time in the GCC and North African region.

Salma Naser Nawayseh was diagnosed with adolescent idiopathic scoliosis in April, after her parents noted the curve in her spine.

They consulted many doctors in the UAE before approaching Dr Firas M Husban, consultant orthopedic surgeon, at Burjeel Hospital. When Salma consulted Dr Husban, she had a thoracolumbar curve of 65 degrees and suffered deformity of the back with shortening of the trunk, lower back hump, un-levelled pelvis, and back pain.

Scoliosis can develop in infancy or early childhood, but it most commonly occurs in children aged 10-15 years.

“Adolescent idiopathic scoliosis is the most common type and is usually diagnosed during puberty. The three treatment options for such patients are observation, bracing, or surgery,” said Dr Husban. While bracing is an option in patients with mild forms of scoliosis, “in Salma’s case, she required surgery to correct the deformity,” he added.

Minimally Invasive Procedure

The traditional method to correct scoliosis is spinal fusion surgery, where two or more vertebrae are permanently joined into one structure using screws and rods. While spinal fusion is the most common method to treat scoliosis, it limits spinal mobility and subsequent growth.

In 2019, the US FDA approved a new treatment called Vertebral Body Tethering (VBT), a minimally invasive technique that allows for continued growth without fusion, while preserving motion and flexibility.

The new treatment enables fusion-less spine correction, allowing the patient to experience the full range of motion and further growth. Its other advantages include discreet incisions, minimal trauma, fewer complications, and faster healing. As Salma had not reached full skeletal maturity yet, she was the perfect candidate for this procedure.

Dr Husban explained, “As opposed to spinal surgeries that involve cutting into the back and manipulating the spinal cord and nerve roots, in this surgery, we make discreet incisions in the abdomen through the endoscope.”

He further said that a flexible cord, called the tether, is attached to the spine on the outside of the curve through bone screws and tension is applied to the tether to straighten the spine. “The tether puts pressure on the outside, allowing the inside of the spinal curve to grow. Because VBT is minimally invasive, there is little trauma to the delicate tissues of your back.”

In this method there is less blood loss, less postoperative pain and a speedier recovery time compared to spinal fusion surgery.

VBT is performed only in a few countries and UAE is now one of them. The first instance of the surgery in the Middle East, a unique and rare medical accomplishment, was performed at the Burjeel Hospital in Dubai.

“Right after surgery, Salma’s spinal curve showed improvement,” said Dr Husban, also pointing out that the curve will continue to improve, and the tether will guide the growth of the spine as the body grows.

Salma is recovering well after the surgery and will be able to go back to school after two weeks. “Four weeks later she can return to full activity with no restrictions and can start playing sports,” the surgeon added.

• UAE: Doctor saves glue-burnt face with rare surgery